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We conducted a study to determine if use of a new flocculant-disinfectant home water treatment reduced diarrhea. We randomly assigned 492 rural Guatemalan households to five different water treatment groups: flocculant-disinfectant, flocculant-disinfectant plus a customized vessel, bleach, bleach plus a vessel, and control. During one year of observation, residents of control households had 4.31 episodes of diarrhea per 100 person-weeks, whereas the incidence of diarrhea was 24% lower among residents of households receiving flocculant-disinfectant, 29% lower among those receiving flocculant-disinfectant plus vessel, 25% lower among those receiving bleach, and 12% lower among households receiving bleach plus vessel. In unannounced evaluations of home drinking water, free chlorine was detected in samples from 27% of flocculant-disinfectant households, 35% of flocculant-disinfectant plus vessel households, 35% of bleach households, and 43% of bleach plus vessel households. In a setting where diarrhea was a leading cause of death, intermittent use of home water treatment with flocculant-disinfectant decreased the incidence of diarrhea.
Received May 16, 2003. Accepted for publication July 5, 2003.
Acknowledgments: We are grateful to Phil Souter, who initially developed the flocculant-disinfectant. We also thank Jesus Velazquez and Laurie Scott for logistical support and critique of the study design, Rudinio Acevedo for help with data management, our team of field workers for careful collection of data, and Sergio Ordoñez and Edwin Ortega for their help supervising field workers and providing medical consultations. Eric Mintz and Robert Quick reviewed earlier drafts of this manuscript and provided useful input.
Financial support: This study was supported by a cooperative research and development agreement between the Centers for Disease Control and Prevention and the Procter & Gamble Company.
Disclaimer: Inclusion of trade names is for identification only and does not imply endorsement by CDC or the Department of Health and Human Services.
Authors’ addresses: Megan E. Reller, Division of Infectious Diseases, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115, Telephone: 617-732-5500, Fax: 617-732-6829. Carlos E. Mendoza, M. Beatriz Lopez, Maricruz Alvarez, Centro de Investigaciones y Adiestramiento en Entomología Médica, Universidad del Valle de Guatemala, 18 Av. 11-95, Zona 15 VH, Guatemala City, Guatemala, Telephone: 50-2-364-0492, Fax: 50-2-364-0354. Robert M. Hoesktra, Biostatistics and Information Management Branch, Centers for Disease Control and Prevention, Mailstop C-09, Atlanta, GA 30333, Telephone: 404-639-4712. Christy A. Olson, Compass Quality Research, 7 Waterbury Court, Little Rock, AR 72223, Telephone: 501-367-0003, Fax: 501-868-6200, Kathleen G. Baier, 3660 Hanley Road, Cincinnati, OH 45247, Telephone: 513-385-2059. Bruce H. Keswick, Personal Health Care R&D, The Procter & Gamble Company, 8700 Mason Montgomery Road, Mason, OH 45040, Telephone: 513-622-4333, Fax: 513-622-4226. Stephen P. Luby, Foodborne and Diarrheal Diseases, Centers for Disease Control and Prevention, Mailstop A-38, 1600 Clifton Road, Atlanta, GA 30333, Telephone: 404-639-4348, Fax: 404-639-2205, E-mail: sluby{at}cdc.gov.
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